{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:46:36Z","timestamp":1766324796072,"version":"3.48.0"},"reference-count":9,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,23]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Tumour necrosis factor alpha (TNF-\u03b1) inhibitors are licensed for use in autoimmune conditions such as psoriasis, and there have been reported cases of liver injury associated with infliximab and adalimumab use. In this case report, we present a case of a woman in her early 30s who was commenced on certolizumab, another TNF-\u03b1 inhibitor, for the management of her psoriasis, having previously trialled other biologics. Thereafter, she developed acutely deranged liver function and subsequently underwent a liver screen and liver biopsy. The histological changes demonstrated an acute severe hepatitis which supported the case of drug-induced liver injury secondary to certolizumab. Following the drug discontinuation, the patient\u2019s liver function tests normalised and, through ongoing follow-up, was noted to remain stable. This case highlights that drug-induced autoimmune-like hepatitis is associated across the TNF-\u03b1 inhibitor class and must be taken into consideration when commencing any of them.<\/jats:p>","DOI":"10.1136\/bcr-2025-266955","type":"journal-article","created":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:45:22Z","timestamp":1766324722000},"page":"e266955","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Certolizumab-associated autoimmune-like hepatitis"],"prefix":"10.1136","volume":"18","author":[{"given":"Eleanor","family":"Peggie","sequence":"first","affiliation":[{"name":"Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0632-5297","authenticated-orcid":false,"given":"Sashrika","family":"Shetty","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Johnston","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"May","sequence":"additional","affiliation":[{"name":"Dermatology, Royal Alexandra Hospital, Paisley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Oien","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Kohnen","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"2025122105451126000_18.12.e266955.1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s12016-012-8305-3","article-title":"Clinical and Histologic Diagnostic Guidelines for Psoriasis: A Critical Review","volume":"44","author":"Johnson","year":"2013","journal-title":"Clinic Rev Allerg Immunol"},{"key":"2025122105451126000_18.12.e266955.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4006"},{"key":"2025122105451126000_18.12.e266955.3","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1001\/jamadermatol.2019.4029","article-title":"Comparison of Biologics and Oral Treatments for Plaque Psoriasis: A Meta-analysis","volume":"156","author":"Armstrong","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2025122105451126000_18.12.e266955.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.12.025"},{"key":"2025122105451126000_18.12.e266955.5","article-title":"Certolizumab-Induced Liver Injury in Ankylosing Spondylitis: A Case Report and Causality Assessment","volume":"16","author":"Bensaghir","year":"2024","journal-title":"Cureus"},{"key":"2025122105451126000_18.12.e266955.6","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2023-256879","article-title":"Certolizumab-induced liver injury: as assessed for causality by the updated RUCAM","volume":"16","author":"Shakhashiro","year":"2023","journal-title":"BMJ Case Rep"},{"key":"2025122105451126000_18.12.e266955.7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1002\/hep.32327","article-title":"A revised electronic version of RUCAM for the diagnosis of DILI","volume":"76","author":"Hayashi","year":"2022","journal-title":"Hepatology"},{"key":"2025122105451126000_18.12.e266955.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.02.014"},{"key":"2025122105451126000_18.12.e266955.9","doi-asserted-by":"crossref","first-page":"7584","DOI":"10.3748\/wjg.v21.i24.7584","article-title":"Autoimmune hepatitis and anti-tumor necrosis factor alpha therapy: A single center report of 8 cases","volume":"21","author":"Rodrigues","year":"2015","journal-title":"World J Gastroenterol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T13:45:23Z","timestamp":1766324723000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":9,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,21]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-266955"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266955","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}